Get Njmmis

Filling out the Njmmis (New Jersey Medicaid Management Information System) online form is essential for healthcare providers aiming to submit claims electronically. This guide provides a clear, step-by-step approach to assist users in completing the form accurately and efficiently.

Follow the steps to fill out the Njmmis form online:

1. Press the ‘Get Form’ button to download the Njmmis form, ensuring it opens in your preferred editor.
2. Begin with the Submitter Information section. Input the name of the provider and the Submitter ID assigned by Molina Medicaid Solutions.
3. Provide the physical address of the Submitter. Ensure it is a physical address, as P.O. Box addresses will lead to rejection.
4. Complete the contact information for the submitter representative, including their name, phone number, and business email address.
5. Fill in the Provider Information section. Enter the New Jersey Medicaid Pharmacy Provider Number and the NPI number.
6. In the NCPDP Transactions section, select the types of transactions intended for submission.
7. For software vendor information, provide details about the software doing the submission or entry. This may include the name, address, and contact details.
8. Make sure to review all filled sections carefully for accuracy and completeness.
9. Once completed, save changes to the document and consider creating a copy for your records.
10. Finally, submit the completed form to Molina Medicaid Solutions via U.S. Mail as instructed.

Complete your documents online using the steps provided for a hassle-free submission experience.